Neuralgia and Post Herpetic Neuralgia

Neuralgia is a sharp pain due to the irritation or damage to nerves and can present in patients for various reasons. The most common type of neuralgia is post-herpetic, which is pain that occurs after a patient has suffered shingles (a viral infection that results in a painful rash). Trigeminal neuralgia, involving the trigeminal nerve in the head, is another common type, which presents as electric-shock-type pain in parts of the face, mouth, teeth, and nose. Occipital neuralgia affects the occipital nerves and results in shooting pain that radiates through the scalp.


The causes of neuralgia vary from infection to trauma. 

You may experience shooting nerve pain after chemical irritation, reactions to medication, kidney disease, diabetes, Lyme disease, Porphyria, or pressure on blood vessels or tumors. Sometimes the cause can’t be identified or could be a combination of several factors.


Pain relievers may provide temporary relief, but can’t control the causes of the pain. Your doctor may instead prescribe anti-convulsants, antidepressants, or muscle relaxers.

In cases where the condition can’t be managed with medication, surgery may be an option. Your doctor may suggest microvascular decompression (the removal of blood vessels affecting the nerves), stereotactic surgery (radiation to the root of the affected nerve), or balloon compression (preventing the nerve from sending pain signals to the brain).

Post Herpetic Neuralgia

The condition that affects the nerves during and after the shingles is called post-herpetic neuralgia. This is the most common form of neuralgia and can last long after the outward symptoms of the shingles disappear. You may begin to experience nerve pain in the area where the shingles outbreak occurred, most often on one side of your torso. This pain can last three months or more after the rash from shingles has faded.

In addition to shooting pain, you may also experience sensitivity to touch, even so far as to find your clothing irritating. Itching and numbness are other signs that you may be experiencing post-herpetic neuralgia.


The chicken pox you had as a child is the same virus that causes shingles. You may experience the reactivation of this virus if your immune system is suppressed, whether due to medications or chemotherapy. If the nerve fibers are damaged during your shingles outbreak, post-herpetic neuralgia can, and probably will, occur. This is because the damaged fibers can’t properly relay pain messages to your brain, causing them to intensify. The resulting pain can last months or even years after the shingles subside.


The possible treatments for post-herpetic neuralgia vary and may need to be used in combination for best results. Your doctor may suggest skin patches with numbing agents like lidocaine. These may be purchased over the counter or, for higher doses, by prescription. A capsaicin skin patch may also provide relief, but these are to be applied by professionals only. Oral medications could include anti-convulsants, antidepressants, and possibly opioid painkillers like tramadol, oxycodone, or morphine.

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